scholarly journals Intramammary lymph nodes: normal and abnormal multimodality imaging features

2019 ◽  
Vol 92 (1103) ◽  
pp. 20190517
Author(s):  
Almir GV Bitencourt ◽  
Eduardo VL Ferreira ◽  
David C Bastos ◽  
Vitor A Sperandio ◽  
Luciana Graziano ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Multimodality Imaging ◽  
Screening Mammography ◽  
Imaging Features ◽  
Breast Carcinomas ◽  
Interval Change ◽  
Inflammatory Conditions ◽  
Pathologic Analysis ◽  
Reactive Hyperplasia

Intramammary lymph nodes (IMLN) are one of the most common benign findings at screening mammography. However, abnormal IMLN features, such as diminished or absent hilum, thickened cortex, not circumscribed margins, increased size or interval change, warrants additional follow-up or pathologic analysis to exclude malignancy. Some benign inflammatory conditions may be associated with imaging-detected suspected abnormal IMLN, such as reactive hyperplasia and silicone-induced lymphadenopathy. In patients with known breast cancer, IMLN are a potential site of locoregional spread, which can change the prognosis and management. In some cases, initial breast carcinomas can also mimic IMLN. Breast radiologists must also be aware of the typical and atypical characteristics of IMLN to suggest further investigation when it is necessary.

Circumscribed Mass: Intramammary Lymph Node

2018 ◽  
Author(s):  
Mark D. Kettler
Keyword(s):  
Differential Diagnosis ◽  
Lymph Nodes ◽  
Breast Imaging ◽  
Three Dimensional ◽  
Screening Mammography ◽  
Imaging Features ◽  
Breast Masses ◽  
Intramammary Lymph Node ◽  
Management Recommendations ◽  
Do So

This chapter, appearing in the section on circumscribed mass, reviews the key clinical and imaging features, differential diagnosis, and management recommendations for intramammary lymph nodes. Benign intramammary lymph nodes are ubiquitous on screening mammography, and whenever it is possible to do so, they should be differentiated from solid masses in order to avoid unnecessary recalls for diagnostic imaging. Three-dimensional tomosynthesis can facilitate the diagnosis of benign intramammary lymph nodes and decrease the number of recalls for supplemental breast imaging. Ultrasound may help in distinguishing between benign lymph nodes and other breast masses when this cannot be accomplished by using mammography alone.

Significance of incidentally detected oval, circumscribed enhancing lesions on preoperative breast MRI.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 12-12
Author(s):  
Jong Yoon Lee ◽  
Mi Jung Jang ◽  
Sun Mi Kim ◽  
Bo La Yun ◽  
Ja Yoon Jang
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma ◽  
Breast Mri ◽  
Imaging Features ◽  
Tubular Carcinoma ◽  
Interval Change ◽  
Mri Features ◽  
Significant Difference ◽  
Preoperative Breast Mri

12 Background: To evaluate the characteristics and malignancy rate of oval, circumscribed enhancing lesions seen on preoperative breast MRI in patients with breast cancer. Methods: From January 2010 through May 2013, a total number of 502 oval, circumscribed mass was incidentally found in 326 patients with breast cancer who had undergone preoperative breast MRI. Seventy-eight lesions were excluded due to the lack of follow-up imaging or total mastectomy. Biopsy was performed when suspicious enhancing kinetics or interval change were detected on MRI. Otherwise, MRI or ultrasound follow up for correlated lesion were performed at least 2 years. Clinical and imaging features were recorded for analysis. Results: Of the 424 oval, circumscribed enhancing lesions detected on MRI, twelve (2.8%) were malignant and 412 (97.2%) were benign. There was no significant difference in size between malignant (0.72±0.26 cm) and benign (0.71±0.34 cm) lesions (p = 0.932). Among 424 lesions, 43 lesions (10.1%) were pathologically confirmed and twelve were malignant. Positive predictive value (PPV) of malignancy for the biopsy was 27.9%. Among 12 malignant lesions, 7 (58.3%) were invasive ductal carcinoma, 4 (33.3%) were ductal carcinoma in situ, and 1 (8.3%) was tubular carcinoma. Of the pathologically confirmed benign lesions, 8 (25.8%) were fibroadenoma, 7 (22.6%) were intraductal papilloma. Interestingly, there were significantly frequent MRI features with early fast enhancement and delayed washout pattern in malignant (11/12) compared to benign (29/412) lesions (p < 0.001). PPV of malignancy for early fast enhancement and delayed washout pattern in MRI was 27.5%. Conclusions: Cancer yield in patients with oval, circumscribed enhancing lesion on preoperative breast MRI was 12 (2.8%) of 424. MRI features with early fast enhancement and delayed washout pattern strongly suggested malignancy.

Prediction of lymph node metastase in NSCLC

2010 ◽  
Vol 01 (05) ◽  
pp. 219-226 ◽  
Author(s):  
F. Beyer ◽  
B. Buerke ◽  
J. Gerss ◽  
K. Scheffe ◽  
M. Puesken ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Fdg Pet ◽  
Automatic Segmentation ◽  
Correlation Coefficients ◽  
Mediastinal Lymph Nodes ◽  
Intra Class Correlation ◽  
Axial Diameter ◽  
Pet Ct ◽  
Fdg Pet Ct

SummaryPurpose: To distinguish between benign and malignant mediastinal lymph nodes in patients with NSCLC by comparing 2D and semiautomated 3D measurements in FDG-PET-CT.Patients, material, methods: FDG-PET-CT was performed in 46 patients prior to therapy. 299 mediastinal lymph-nodes were evaluated independently by two radiologists, both manually and by semi-automatic segmentation software. Longest-axial-diameter (LAD), shortest-axial-diameter (SAD), maximal-3D-diameter, elongation and volume were obtained. FDG-PET-CT and clinical/FDG-PET-CT follow up examinations and/or histology served as the reference standard. Statistical analysis encompassed intra-class-correlation-coefficients and receiver-operator-characteristics-curves (ROC). Results: The standard of reference revealed involvement in 87 (29%) of 299 lymph nodes. Manually and semi-automatically measured 2D parameters (LAD and SAD) showed a good correlation with mean

Radiologic Findings of a Rare Subtype of Invasive Breast Cancer with Poor Prognosis: Metaplastic Carcinoma of the Breast

2019 ◽  
Vol 15 (3) ◽  
pp. 338-348
Author(s):  
Hale Aydin ◽  
Bahar Guner ◽  
Isil Esen Bostanci ◽  
Nazan Ciledag ◽  
Melda Boyacioglu Bulut ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Multimodality Imaging ◽  
Metaplastic Carcinoma ◽  
Imaging Features ◽  
Mri Findings ◽  
Radiologic Findings ◽  
Round Shape ◽  
Malignant Feature ◽  
Imaging Results ◽  
Metaplastic Breast Carcinoma

Background and Objectives: The purpose of this study was to evaluate the mammographic, sonographic and MRI findings of metaplastic breast carcinoma. Methods: In this retrospective review study, we analyzed the medical files of 9600 patients who were treated for invasive breast cancers. Clinical information, histopathologic and radiologic findings of 65 patients were included in this study. All existing radiologic images and medical reports were reviewed retrospectively. Thirty-three patients had MG, 58 patients had US and 7 patients had MRI imaging results. Results: Mammographically, the most frequent presentations of MPBC were round shape, microlobulated margin and high density masses. Calcifications with or without masses were not a frequent finding. The most common sonographic findings were round shape, partially indistinct angular margin, hypoechoic and heterogeneous echo patterns and no posterior feature masses. All lesions were presented as masses rather than non-mass enhancements on magnetic resonance imaging. Features of masses had more malignant feature on MRI than other modalities in all 7 patients. Conclusion: Metaplastic breast carcinoma is one of the rarest poorly differentiated invasive breast carcinomas. Interestingly, these aggressive tumors demonstrate benign or moderately malign features on imaging methods. This appearance of MPBC can cause it to be misdiagnosed as a benign breast lesion especially in young women. MPBC should be kept in mind in the differential diagnosis of large palpable breast masses. Therefore, follow-up at short intervals and/or multimodality imaging studies which include breast MRI are important for the diagnosis of MPBC.

scholarly journals Oral findings during follow-up of nasopharyngeal squamous cell carcinoma treatment: A case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110330
Author(s):  
Atsushi Musha ◽  
Nobuteru Kubo ◽  
Naoko Okano ◽  
Hidemasa Kawamura ◽  
Yuhei Miyasaka ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Concurrent Chemoradiotherapy ◽  
Nasopharyngeal Cancer ◽  
Inflammatory Conditions ◽  
Positron Emission ◽  
History Of ◽  
Oral Area

A 50-year-old woman with a long history of nasopharyngeal cancer (T2N2M0, squamous cell carcinoma) underwent chemoradiotherapy and surgery. In the past, to prevent tumor recurrence or metastasis, she underwent concurrent chemoradiotherapy or neck dissection. However, during a follow-up 10 years after the surgery, intense F-18 fluorodeoxyglucose uptake was detected in the oral area (SUVmax 6.0). A biopsy of the area with F-18 fluorodeoxyglucose uptake revealed pathological inflammation. Radiography showed the presence of a wisdom tooth, located at the F-18 fluorodeoxyglucose accumulation site, and pericoronitis of this tooth was detected. Our findings indicate the importance of considering the effect of inflammatory conditions, such as periodontal disease, in using F-18 fluorodeoxyglucose positron emission tomography/computed tomography during follow-up after head and neck cancer treatment.

scholarly journals Multimodality imaging review of focal renal lesions

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Jonathan Lyske ◽  
Rishi Philip Mathew ◽  
Christopher Hutchinson ◽  
Vimal Patel ◽  
Gavin Low
Keyword(s):  
Malignant Tumors ◽  
Multimodality Imaging ◽  
Lymphoproliferative Disease ◽  
Benign Tumors ◽  
Main Body ◽  
Imaging Features ◽  
Focal Lesions ◽  
Renal Lesions ◽  
Positron Emission ◽  
Neoplastic Lesions

Abstract Background Focal lesions of the kidney comprise a spectrum of entities that can be broadly classified as malignant tumors, benign tumors, and non-neoplastic lesions. Malignant tumors include renal cell carcinoma subtypes, urothelial carcinoma, lymphoma, post-transplant lymphoproliferative disease, metastases to the kidney, and rare malignant lesions. Benign tumors include angiomyolipoma (fat-rich and fat-poor) and oncocytoma. Non-neoplastic lesions include infective, inflammatory, and vascular entities. Anatomical variants can also mimic focal masses. Main body of the abstract A range of imaging modalities are available to facilitate characterization; ultrasound (US), contrast-enhanced ultrasound (CEUS), computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET), each with their own strengths and limitations. Renal lesions are being detected with increasing frequency due to escalating imaging volumes. Accurate diagnosis is central to guiding clinical management and determining prognosis. Certain lesions require intervention, whereas others may be managed conservatively or deemed clinically insignificant. Challenging cases often benefit from a multimodality imaging approach combining the morphology, enhancement and metabolic features. Short conclusion Knowledge of the relevant clinical details and key imaging features is crucial for accurate characterization and differentiation of renal lesions.

scholarly journals Cement bridging phenomenon in percutaneous vertebroplasty for adjacent vertebral compression fracture

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yun-Da Li ◽  
Tsung-Ting Tsai ◽  
Chi-Chien Niu ◽  
Po-Liang Lai
Keyword(s):  
Vertebral Compression Fracture ◽  
Body Height ◽  
Compression Fracture ◽  
Plain Film ◽  
Imaging Features ◽  
Height Ratio ◽  
Kyphotic Angle ◽  
Anterior Body ◽  
New Onset

AbstractIn some cases of vertebroplasty for adjacent fractures, we observed a cement bridging phenomenon, in which the injected cement flowed from the newly fractured vertebra to the previously cement-augmented vertebra through the space between the abutting anterior longitudinal ligament and the vertebral column. The purpose of this retrospective study was to investigate this phenomenon. From January 2012 to December 2014, patients who sustained new-onset adjacent vertebral compression fracture and who were again treated with vertebroplasty were enrolled. We divided the patients into two groups, the bridging group and the nonbridging group, to analyze the difference between them. Results showed that the cement bridging phenomenon occurred in 18 (22.8%) of the 79 patients. Significant differences between the bridging and nonbridging groups were identified in the following 3 imaging features: severe loss of the anterior vertebral body height at the new-onset adjacent vertebra on plain film (odds ratio [OR] = 4.46, p = 0.014), fluid accumulation (OR = 36.27, p < 0.001) and hypointense signaling (OR = 15.67, p < 0.001) around the space anterior to the abutting vertebral bodies and the corresponding intervertebral disc on MRI. After a 2-year follow-up, both the mean value of the focal kyphotic angle and anterior body height ratio were significantly better in the cement bridging group than in the nonbridging group. The cement bridging phenomenon, which has never been reported in the literature, is not rare in clinical practice. This phenomenon was associated with better maintenance of focal kyphotic angle and anterior body height ratio during the 2-year follow-up.

scholarly journals Multiple pericardial hematomas: a case report and mini-review in multimodality imaging

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aninka Saboe ◽  
Ferdy Sanjaya ◽  
Raden Erwin Affandi Soeriadi ◽  
Euis Maryani ◽  
Nuraini Yasmin Kusumawardhani ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiac Imaging ◽  
Single Photon ◽  
Multimodality Imaging ◽  
Photon Emission ◽  
Vena Cava ◽  
Intracardiac Thrombus ◽  
Surgical Closure ◽  
The Right

Abstract Background Pericardial hematoma is blood accumulation in the pericardial space. Although rare, it could arise in various conditions, such as after cardiac surgery. Clinical diagnosis of pericardial hematoma is implausible; thus, cardiac imaging plays a pivotal role in identifying this condition. We presented a case of multiple pericardial hematomas, which was found as an incidental finding in post-cardiac surgery evaluation. We highlighted the diagnostic challenge and the key features of multi-modality cardiac imaging in pericardial hematoma evaluation. Case presentation An asymptomatic, 35-years old male, who underwent surgical closure of secundum atrial septal defect (ASD) one month ago, came for routine transthoracic echocardiography evaluation. An intrapericardiac hematoma was visualized at the right ventricle (RV) 's free wall side. Another mass with an indistinct border was visualized near the right atrium (RA). This mass was suspected as pericardial hematoma differential diagnosed with intracardiac thrombus. Cardiac computed tomography (CT) scan showed both masses have an attenuation of 30–40 HU; however, the mass's border at the RA side was still not clearly delineated. Mild superior vena cava (SVC) compression and multiple mediastinal lymphadenopathies were also detected. These findings are not typical for pericardial hematomas nor intracardiac thrombus; hence another additional differential diagnosis of pericardial neoplasm was considered. We pursued further cardiac imaging modalities because the patient refused to undergo an open biopsy. Single-photon emission computer tomography (SPECT)/CT with Technetium-99 m (Tc-99 m) macro-aggregated albumin (MAA) and Sestamibi showed filling defect without increased radioactivity, thus exclude the intracardiac thrombus. Cardiac magnetic resonance imaging (MRI) reveals intrapericardial masses with low intensity of T1 signal and heterogeneously high intensity on T2 signal weighted imaged and no evidence of gadolinium enhancement, which concluded the diagnosis as subacute pericardial hematomas. During follow-up, the patient remains asymptomatic, and after six months, the pericardial hematomas were resolved. Conclusion Pericardial hematoma should be considered as a cause of pericardial masses after cardiac surgery. When imaging findings are atypical, further multi-modality cardiac imaging must be pursued to establish the diagnosis. Careful and meticulous follow-up should be considered for an asymptomatic patient with stable hemodynamic.

scholarly journals Retrospective analysis of the clinical presentation and imaging of eight primary benign mediastinal schwannomas

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Ramiro Sandoval-Macias ◽  
Irving Daniel Ortiz-Sanchez ◽  
Ana Lilia Remirez-Castellanos ◽  
Luis Mora-Hernandez ◽  
Candelaria Cordova-Uscanga ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Signs And Symptoms ◽  
Cystic Degeneration ◽  
Imaging Features ◽  
Posterolateral Thoracotomy ◽  
Accurate Analysis ◽  
Cystic Changes ◽  
History Of ◽  
Histology And Immunohistochemistry

Abstract Objective Mediastinal schwannomas are sometimes confused with other neoplasms during initial radiological studies, especially when there is a history of cancer in another area. In these cases, a more accurate analysis using computed tomography (CT) or even magnetic resonance (MRI) is required. Our study aimed to perform a retrospective analysis of the clinical and imaging features for a series of patients with mediastinal schwannomas that were confirmed by histology and immunohistochemistry. Results We found eight patients, five men and three women, with an average age of 51 years for this study. The main signs and symptoms at diagnosis were chest pain, dyspnea, cough, and dysphagia. CT showed that the tumor was located in the posterior compartment of the chest in 7/8 cases. Tumors > 10 cm were more heterogeneous and showed cystic changes. All patients underwent posterolateral thoracotomy, and radiological follow-up showed no evidence of recurrence. Histological analysis was considered the gold standard to confirm diagnosis, along with at least one neurogenic IHC marker. In conclusion, mediastinal schwannomas are benign encapsulated tumors. According to CT, schwannomas > 10 cm show cystic degeneration more frequently. Posterolateral thoracotomy allows complete resection and is considered the surgical approach of choice.

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